New trial for young people

An important new study will investigate whether a new treatment will improve the outcomes of young people  being treated with antithyroid drugs for Graves’ disease (hyperthyroidism).

What will the study do?

Treating Graves' Disease (GD) is more difficult in young people because standard antithyroid drug therapy (ATD) is more likely to result in side-effects and less likely to result in cure when treatment is stopped. Only 1 in 4 patients will require no further treatment after 2 years of ATD. Rituximab (RTX) medication is used to treat many immune disorders. It works by targeting the blood cells that make the antibodies responsible for attacking the thyroid in GD. 

A recent exploratory study in young patients with GD suggested that giving just one dose of RTX in addition to standard ATD is well tolerated and may increase the likelihood of remission. This has the potential to reduce the number of young people who need to have surgery, radioiodine treatment or be on long-term antithyroid drug treatment. This is an exciting finding that needs to be explored in a bigger trial.

Study aim

The study will be run by Dr Claire Wood and colleagues at Newcastle University. It aims to determine whether a single dose of rituximab, given in addition to 2 years of anti-thyroid drug, increases the remission rate in young people with Graves' disease. 

What the study involves

The researchers will recruit 124 young people (12-24 years old) to be randomly allocated to either the usual treatment of a 2-year course of ATD tablets, or a single dose of RTX as well as 2 years of ATD.  Participants will have blood tests taken to check thyroid levels at 4 weeks, then every 8 weeks in the first year and 3- monthly thereafter. The number of visits is similar to standard NHS care.  If RTX improves the number of people with normal thyroid tests, it could be offered more widely as a treatment in the future. 

How to get involved

The study has now opened at Hull Royal Infirmary, with several other centres opening shortly. Please contact your local endocrinologist if you have been diagnosed with GD in the last 12 weeks and would like to take part.